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General NPI Number Information
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NPI Number | 1730039587
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Entity Type | Organization
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Legal Business Name | CANARYCHIC ENTERPRISES, INC
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Dates
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Enumeration Date | 01/31/2026
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Last Update Date | 01/31/2026
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Provider Practice Location Address
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Address Line | 5218 JAMMES RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-7700
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Country | US
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Telephone | 904-442-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 15828 BAINEBRIDGE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32218-8325
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LESLIE PENNINGTON
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Credential |
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Telephone | 904-299-9198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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